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tv   [untitled]    June 17, 2012 4:00pm-4:30pm PDT

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care in san francisco. this provision was crafted specifically in response to the health reform, and the 30,000 individuals being transitioning from uninsured and relied on charity care services to becoming ensured and participating in medi-cal managed care to the cost of caring is seeds the reimbursement by medi-cal, and the development agreement limits cpmc's and reimbursed costs for seven to 10,000 but a fair share is to $9.5 billion per year, adjusted annually for medical inflation. the city conducted actuarial analysis and predicted rates of service utilization by these new to those of patients and is confident that the $9.5 million of parliament will be sufficient to ensure that all 10,000 beneficiaries can be cared for in this managed care system. i mentioned that this provision was specifically crafted in response to health reform and will move health care into the future.
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although health reform will reduce the number of uninsured who rely on charity care services, it will not eliminated. the need for charity care and other care for san francisco's low-income populations will remain, which is why the maintenance of the baseline commitment was an important element in the development agreement. as director garcia mentioned, the supreme court is currently reviewing health reform and is expected to render its decision this month. it is unclear how the court will rule. however, even if it is wholly or partially start them, the state can implement many of the provisions of health reform and have stated its intent to do so. the development agreement does include a provision that requires that the city and cpmc meet and confer a there is a change in the law that renders any portion of the development agreement unachievable. if it comes to that, i suspect we would discuss a range of alternatives depending on how the court rules, but i imagine our discussions that address increasing levels of charity
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care and other services for low- income san franciscans. in accordance with the third goal the director garcia mentioned, focusing cpmc's community benefits on san francisco's most vulnerable populations, $20 million community care innovation fund will be established under this a deval agreement and will help the san francisco community- based clinics develop the capacity to thrive under reform. this will develop the infrastructure and capacity of the existing primary care provider serving tenderloin residence, to enable them to participate in medi-cal managed care. this will help clinics to be partners with cpmc if they strive to meet their obligations, but also the clinics can participate more broadly in managed care. in addition, the community care innovation fund will support other community-based health and human services providers with a particular focus on san francisco's lowest income and
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highest need it neighborhoods. the da requires cpmc to maintain 100 skilled nursing facility beds in san francisco for 10 years. cpmc currently provides skilled nursing care for approximately 100 patients. 38 beds at the davies campus. approximately 60 patients receiving skilled nursing care at st. luke's. cpmc will maintain 38 beds at the campus, but they're not proposing to include skilled nursing beds at the new st. luke's hospital, but there will add 62 new beds in san francisco. all 100 will accept patients with medi-cal, medicare, and/or private insurance. finally, the da would require that cpmc provide a range of other health benefits. these include working with dph and other hospitals to develop proposals for subacute care in san francisco, which occurred about earlier.
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continuing efforts to integrate the medical staff of all of its campuses. continuing to active phillippe partner in the community partnership, a coalition of hospitals, clinics, dph, and others. there will continue to provide certain specialty services to chinese hospital patients in accordance with their agreement with chinese hospital. they will deliver culturally and linguistically appropriate services. supervisor mar: did you explain with the san francisco community benefits partnership is? >> a coalition of hospital, clinics, and other partners that came together several years ago under state law that requires nonprofit hospitals in san francisco -- in the state to conduct a community-needs assessment and develop community benefits plan to meet the needs of those communities. underlying that is the assumption that nonprofit hospitals have an obligation to serve the needs of the communities that they are in.
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under health reform, it is now federal law that they do this. supervisor mar: thank you. >> this concludes our overview of the proposed development agreement. a more detailed discussion in da the is scheduled for your june 25 hearing. i will end my presentation at this point. supervisor mar: thank you. >> i am going to take about 67 minutes to go through the rest of the overview. then we will be on to the detail work force discussion. -- six or seven minutes. very quickly, we will go over this again in detail at a future hearing. the goals are to protect the city from unexpected premium increases for hhs covered patients in network with the cpmc p -. it cannot raise premiums by more
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than 5% per year for the first three years, and medical inflation rate plus 1.5%. for patients out of network but who end using cpmc facilities, they will receive the same out of network rate as other employers that contract with blue shield. obviously, this is a very complex subject. the director of the health service system will be here to discuss an answer questions on july 9. work force, really quick, because you're going to hear more about it. three things. local hire for construction, agreements around permanent jobs, and a $2 million grant to support workforce training. on housing, we're talking about an agreement to spend about the $4.5 million from cpmc to replace 25 displaced units, displaced by the actual construction, as you see there on the slide.
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relocation benefits we are engaged in with cpmc and the tenants are resulting in a relocation packages and agreements with all of the affected tenants. the meat of the housing part is the affordable housing funding, which adds up, as you see, to $29 million to the mayor's office of housing for 100% of portable development. $29 million to the mayor's office for a downpayment assistance loan program for cpmc employees that make up to 100% of area median income. to the extent that money is not used within a certain number of years, it flows back to the mayor's office for things like affordable housing. of the entire down payment program is used, when that money is paid back, when units are sold, put together with some appreciation that the city gets, there will be another $35 million flowing into the city from that.
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moving to transportation, and again, we will get to all of these in detail at later hearings. the meat of its transportation board is providing funding to mta for transit facilities and service. the location of a major new medical facility in the center of the city at a location well- served by transit is generally a good thing. not surprisingly, additional investment in muni service will be required to carry these additional passengers. this is reflected in the first two funding obligations on the slide. $5 million toward the van ness and geary brt projects, and $10.5 million will be paid by cpmc to mta in lieu of the transit effective element feet, the tidf, which is not required by law of a nonprofit. in addition, cpmc will impose a parking surcharge of 50 cents off peak and 75 cents on peak for all entries and exits to the
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cathedral built garages. this will serve as an incentive to use the non-automobile modes of arriving at the hospital for those who can, and it will raise an estimated additional $500,000 per year or $5 million over the 10 years for mta service. last but not least, cpmc will provide a one-time payment of $400,000 to mta for planning for improved bicycle access around and between cpmc's campuses. moving to the related issue a pedestrian safety and streetscape improvements. around cathedral, the agreement is that cpmc will provide $9.35 million in cash to the city, which will then go ahead and make the improvements that you see on at this live here. the bulk of these, about $8 million, will go to the first three items on the list. pedestrian lighting in the tenderloin, the conversion of one-way to two-way streets which
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is a traffic safety issue, and some additional pedestrian safety things. cpmc will fund a tenderloin safe passage pilot program. and then, is a partner the lowerpolk cbd should it be established, and the seed grant of $1 million. that $1 million, in cbd does not establish, flows to the city instead for similar types of improvements. around the other two campuses, starting with davies, the structure here is different. we agreed on a list of pedestrian improvement projects that cpmc will build along with the hospital project. these are over and above the things that are physically part of the project. so the things that cpmc does in conjunction with building a building, like lightening the sidewalks and things like that, are not on this list. but in addition to those things, cpmc has agreed to do what we estimate to be4 $75,000 worth of
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improvements. $475,000 estimate is for our convenience. they are of filled -- obligated to do the list whether that is the cost or not. that is just what we think will be the cost. it is the same structure around st. luke's campus. the total cost is assumed to be around $3.3 million. the items in front of you are the items that cpmc has agreed to do along with the construction project. that is over and above the things that have been directly with the hospital building. again, almost at the end here, we tried to take a very complicated subject and make it as simple as we could. with the timing of the public benefit flowing into the city. at the the best thing to do in terms of right now is to look at the bottom of this table. we would be happy to go over it in more detail at a later time. but what this shows you, with respect to the cash obligations,
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this does not try to deal with the ongoing health care, but just the cash obligations, that the majority of those come in in the sort of near-term, with the bulk of them coming as soon as any litigation on the project is resolved, and then some of them coming a little bit later. basically, all of the cash support for affordable housing and all the cash support for transportation is basically into the city by the time the hospital opens in 2017. just in a summary, i want to summarize that we think this provides two new seismically safe hospitals. it prepares the city for federal health care reform, as you'll hear a lot more about. it has accused the future of st. luke's hospital. it provides strong local hire for construction and other jobs. and more than $1 billion worth
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of bagram health care services, it also provides a commitment of $117 million in one-time community benefits, including any count the cash recovery on the affordable housing, $93 million worth of affordable housing. this concludes my overview of the da. we will get back to these subjects in the future. now i will have rhonda simmons come up into it is through detailed the job creation part. supervisor mar: thank you so much. ms. simmons. >> at thank you, supervisors. i am from oewd. i am going to talk a little bit more in detail on the work force portion of this agreement, as i have been working closely with all the parties involved. so the first caveat for me is to clarify a few things around the work force policy that we have
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used on this project. this project does not fall under local hire, so that is actually a mistake. it falls under our first source policy could a it is considered a first source, which is all are privately funded projects fit in terms of the legislation and the laws that we used to get san franciscans employed. it is chapter 83 in our code, and it really speaks to economically disadvantaged residents. so that is sort of the framework, if you will, that we have said our work force program under. ideally, we are trying to create career pathways for san franciscans that may not otherwise have those jobs that are much more entry-level focused. we have tried to strengthen some partnerships with the city through our training academies, with our partnerships with cbo's, there isan an lbe bill
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that will be in the gsa's office. that is local business enterprises. i will talk about that at the end. does a little background on cpmc, and you have heard this already earlier in the presentation. cpmc is the second-largest private employer in san francisco, the fourth largest employer, including but -- public agencies. the rebuild has two components in terms of jobs. it will create 1500 construction jobs over the life of the project, and there will be 1500 permanent jobs added over a 10- year time span, so that is about 150 roughly a year. they hope to retain 622 jobs in -- 6200 jobs in san francisco, and these are jobs that exist.
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45% of that number are san francisco residence. and you can see the average wage of employment compensation. this is a cross their whole spectrum of jobs. according to cpmc, their projected job growth is broken down as follows. this is pretty self-explanatory. starting with management positions, registered nurses positions, and then it goes from there. within the last, say, four or five buckets, there are intermixed the number of entry- level jobs, which has been my focus. we define entry-level last two years of education or less. so within those licensed vocational nurses, some of the technical positions, the aids and the orderly's, some of the clerical and administration, and environmental food services.
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that definition that i mentioned applies. >> i was looking at a section da of the -- of the da, and it seems to state that entry-level is less than two years. is it two years or less or less than two years? >> for us, it is two years or less, roughly. when i look at my placements out of the health care academy, they follow little bit more under less than two years, but we changed periodically in terms of our certification. it is across all hospitals, not just cpmc. >> i am looking at, say, section a-2e. it refers to less than two years. is that a mistake? it should be two years or less. >> yeah, i think that the time we were doing that -- we have been working on this now for a couple years, and our academy
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had started. so it was at that two years or less. it may be a little different. when i look at the data, which you'll see a little bit more about the health care sort of data that i have, probably keeping it less than two years is fine. i mean, you can get into a lot of semantics about this stuff. it is going to change based on the market is going to tell you about these positions anyway. i mean, i do not know, it is a new ones question. but i think the way it is in the da is fine, for my purposes. >> the intent was two years or less. i ask that because rn's are not included. can you explain why that was the case? >> for my health care academy, i do not have a training program for rn's. gender 83 really focuses more on a set of folks that are not at that skills that -- chapter 83. so for my office and what we do,
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i do not have any programs necessarily for rn's, and that is how this was set up. i do not necessarily have a pool to draw from. it just does not sit in my purview. that is how this got negotiate, just from the work that i do. supervisor mar: i know you're going to get to future slides. but it looks like the existing jobs, 6200 jobs will be maintained, and there's about a 25% increase in new jobs, and we're talking about the permitted jobs. what percentage would you estimate are those entry-level of the new jobs that are created? >> if you let me continue, we will get to it. supervisor mar: ok. >> i am going to focus on construction first, because that is the way it is laid out. once again, our first source policy -- this is a privately
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funded project, and there's an estimated 1500 construction jobs that will be created. this is a labor agreement attached to it. the agreement calls for about 30% of construction trade hours with the project overall. and for each contract, we try to achieve those goals by trade. that does mirror some of the language we have in local hire. it is currently a 25% on our local hire. just to give you a little bit of comparison, because a number of you guys have asked me about local hire and if it applies. supervisor chiu: do have a copy of the pla? >> it is an agreement between cpmc and their contractors and unions, so i have not been privy to the pla. it is their agreement, not our agreement.
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it is not like the agreements we have with puc or anything like that. >> which i appreciate. i know it is referenced. i dig it would be helpful for us of ricketts see a copy of that. >> i have not been provided a copy, and we can talk to cpmc and see if it is possible to see a copy. but no city staff has seen the copy of that. >> ok. i think that would be helpful, or i would ask our friends in the trades if we may see that. i do not know what the agreement is around that, but i think that would be helpful. thank you. >> in addition to the trades- related positions, we also have agreement that 50% of the sort of the new entry-level admin and engineering positions, you know, are part of this agreement. we started a construction admin program, which is where this is
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applicable for us. we probably average about two classes a year and turn out about 60 students the could partake in that opportunity, and we have already started working with cpmc on that. the new apprenticeship positions, 50% of our city build graduates will have access to those positions, and then we will work in partnership with cpmc on the additional 50%. meaning that if they are not able to achieve those through their means, then we will be ready. we probably have two city build classes a year. we just graduated a class last friday with 50 students wi. the more students to graduate, the more students we're able to put in place. the other key components to the construction is that there is a commitment by cpmc to create and administer a program to ensure
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that students actually can journey out based on the trade, which is important. that is equivalent to essentially folks being able to a journey out in their craft, and in this world, that is really sort of the gold you strive for from a construction component, so it is really a retention program that would be new for us. we do not really have a commitment like this on any other project. the other part of this is the city collaboration with the contractors. they will be required, as all contractors that are subjected to first source, to alert and let us know. we have a system in place on the opportunities. failure to do so, they will be in what we call our first source of violation. there are liquidated damages attached to the first source policy that this project is subjected to, that liquidated
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damages apply to the contractors. in terms of how we define the san francisco residence, it is very much like what we have in our local hire policy, and the project will have the requirement of demonstrating residency in san francisco, which is really -- what it means is that you need to meet the threshold of voter registration in order for us to consider you a san francisco resident. and that policy would apply it. it is also part of our local hire policy. hopefully this will begin to answer some of the questions that you all have on the entry- level or in-use portion of this. as i mentioned earlier, there are 6200 jobs overall. there are roughly about 122 entry-level jobs annually, according to cpmc's information.
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100 of those positions exist, and 100 will become available due to attrition, promotion, retirements, things of that nature, and then another 22 will be for newly created positions as the hospital is built. the definition, as we said, requires two years or less of the post-secondary education. these are some of the examples that we used to kind of come up with that definition or sort of attached what my program trains or what we thought people could get some employment in. as i said before, we did not necessarily focus on management positions, hire skilled health care positions. that really was not the focus at the time of negotiating this. there has been and continues to be discussions around the sort of non-health care as entry
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level positions, such as some of the admin and food-service kind of positions. we continue to have those discussions. but most of the focuses on more of an entry level pool, and that has more to do with the work that my office and those which is more a round that type of skill set, more so than anything else. at least from our perspective. of that 122 pool, there is a commitment of 40 per minute entry level jobs over a five- year time span. they roll over if we do not meet that goal, but i think we can. that is about a third of the positions that i have data on. we will have our mou agreements on all of this. the partnership includes a cbo
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consortium that i use on just about everything we do in this work, and there has been some commitment to target residents, and i heard this from the board of supervisors, where we have potentially higher levels of unemployment. so you can see what committee focuses we have identified so far based on that criteria. supervisor mar: i have a filling others will have questions about this topic, but in the previous slide cammisa this project, with the rebuild, you'll have about 7700 jobs over the next 10 years. of that, about 40 jobs a year -- goods actually, there is 1500 new jobs that gets created. the data have been given, there are 6200 jobs that exist across all cpmc.
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of those, about 100 of those jobs sort of the exist, because there is a sort of retention and creation, two separate buckets. the 100 is sort of existing positions were there will be turnover. however that turnover occurs, retirement, people leave, promotions. then there is another roughly, with the definition i have, you know, 22 sort of entry level that meet that goal, so that gives you 122 that i am going to approach. not the whole 6200 pool of jobs that exist, nor does it cover the whole 1500 pool, because that is much broader. if you go back to look at the original side of how many management positions, how many rn positions, and all that, that encompasses sort of the whole entire bucket.
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that is not the pool that my work is totally focused on. there is a number of those position left outside of my purview. most of the more highly skilled positions, we did not focus on. anything, i would say, that is rn, md, ma, ba level was not my focus on this. i think that is where some of the confusion lies. as i said, that is not how i am set up in terms of, you know, the money that i receiver any of that. it is much more for folks that are sort of lower skilled and just kind of getting into the game. that is really where that comes from. supervisor mar: and i completely appreciate that. what i am wondering is, for permanent jobs moving forward, it seems that there are only about 40 jobs per year under your purview, what you're focused